Avaliação Psicológica

ISSN: 1677-0471
[email protected]
Instituto Brasileiro de Avaliação
Psicológica
Brasil

de Oliveira, Camila Rosa; Baptista Mendes Pedroso de Lima, Margarida Maria; Silva
Esteves, Cristiane; Gonzatti, Valéria; Ribeiro Viana, Susy Ane; Quarti Irigaray, Tatiana; de
Lima Argimon, Irani Iracema
Normative data of the Brazilian elderly in Logical Memory subtest of WMS-R
Avaliação Psicológica, vol. 16, núm. 1, 2017, pp. 11-18
Instituto Brasileiro de Avaliação Psicológica
Centro Itatiba, Brasil

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ARTIGO – DOI: 10.15689/ap.2017.1601.02

Normative data of the Brazilian elderly

in Logical Memory subtest of WMS-R
Camila Rosa de Oliveira1
Faculdade Meridional – IMED, Passo Fundo-RS, Brasil
Margarida Maria Baptista Mendes Pedroso de Lima
Universidade de Coimbra, Coimbra, Portugal
Cristiane Silva Esteves, Valéria Gonzatti, Susy Ane Ribeiro Viana, Tatiana Quarti Irigaray, Irani Iracema de Lima Argimon
Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre-RS, Brasil

ABSTRACT
The aim of this study was to establish normative data for the Brazilian elderly population in the Logical Memory (LM) subtest of the
Wechsler Memory Scale, revised version (WMS-R) and investigate the ability of scores in this subtest (immediate and delayed recall)
to discriminate the elderly with and without depressive symptoms. The sample consisted of 334 elderly participants. Participants
answered a sociodemographic and health questionnaire, the MMSE, the GDS-15, and the LM subtest. Data were analyzed by
descriptive statistics, Student’s t test, multiple linear regression, univariate analysis, and discriminant analysis. Age, education, and
depressive symptoms significantly influenced all the scores of LM. Normative data were available according to three age groups, three
levels of education, sex, and presence or absence of depressive symptoms. Results are in agreement with the literature, demonstrating
the importance of establishing reference standards in accordance with sociodemographic and cultural characteristics.
Keywords: aging; verbal memory; memory; cognition.

RESUMO – Dados normativos de idosos brasileiros no subteste Memória Lógica da WMS-R

O presente estudo teve por objetivo estabelecer dados normativos a idosos brasileiros no subteste Memória Lógica (ML) da WMS-R
e investigar a capacidade dos escores desse subteste (recordação imediata e tardia) para discriminar idosos com e sem sintomas
depressivos. A amostra foi composta por 334 idosos. Os idosos responderam a um questionário sociodemográfico, ao MEEM, à
GDS-15 e ao subteste ML. Os dados foram analisados por estatística descritiva, teste t de Student, regressão linear múltipla, análise
univariada e análise discriminante. A idade, escolaridade e sintomas depressivos influenciaram significativamente todas as pontuações
da ML. Os dados normativos foram disponibilizados de acordo com três grupos etários, três níveis de escolaridade, sexo e presença ou
ausência de sintomas depressivos. Os resultados estão de acordo com a literatura, demonstrando a importância de estabelecer padrões
de referência de acordo com características demográficas e socioculturais.
Palavras-chave: envelhecimento; memória verbal; memória; cognição.

RESUMEN – Datos normativos de los adultos mayores brasileños en sub-test de Memoria Lógica de WMS-R
Este estudio tuve como objetivo establecer los datos normativos para mayores brasileños en la sub-prueba de la Memoria Lógica
(ML) de la Escala de Memoria de Wechsler, versión revisada (WMS-R), e investigar la capacidad de las puntuaciones de la sub-prueba
(memoria inmediata y retardada) para discriminar mayores con y sin los síntomas depresivos. La muestra se compuso de 334 personas
mayores. Los participantes respondieron a un cuestionario sociodemográfico y de la salud, lo MEEM, la GDS-15 y la sub-prueba
de ML. Los datos fueron analizados utilizándose la estadística descriptiva, la prueba t de Student, la regresión lineal múltiple, el
análisis univariado y el análisis discriminante. La edad, la educación y los síntomas depresivos influenciaron significativamente todas
las puntuaciones de la ML. Los datos normativos incluyen tres grupos de edad, tres niveles de educación, el género y la presencia o
ausencia de los síntomas depresivos. Los resultados son consistentes con la literatura, lo que demuestra la importancia de establecer
puntos de referencia de acuerdo a las características sociodemográficas y culturales.
Palabras clave: envejecimiento; memoria verbal; memoria; cognición.

Difficulties in recalling recent events are generally episodic memory (VEM) could also be observed in the
associated with mild cognitive impairment and degener- normal aging process (Celsis, 2000), indicating a pos-
ative neurological disorders such as Alzheimer’s Disease sible development of dementia (Chapman et al., 2011a).
(AD) (Salthouse, 2014). However, impairment in verbal Several studies have suggested the influence of age on

Correspondence address: Rua Senador Pinheiro, 304, 99070-220, Passo Fundo-RS, Brasil. E-mail: camila.oliveira @imed.edu.br
1

Avaliação Psicológica, 2017, 16(1), 1-18 11

 Oliveira, C. R., Lima, M. M. B. M. P., Esteves, C. S., Gonzatti, V., Viana, S. A. R., Irigaray, T. Q., & Argimon, I. I. L.

VEM, comparing the performance of young adults, The LM subtest of WMS-R (Wechsler, 1987) is
adults, and the elderly in recalling wordlist tests or retell- widely used in VEM impairments and has proven to be
ing stories (Correia & Osorio, 2013; Silver, Goodman, & a major clinical and scientific task in assessing the el-
Bilker, 2012; Vlahou et al., 2013). derly with and without cognitive disorders, other than
Although there are relevant gaps between differ- AD (Laske et al., 2015). Other clinical pathologies such
ent age groups, education has proven to be the factor of as depressive symptomatology may also influence the
higher impact on VEM performance, as well as on other test results (Maeshima et al., 2013). However, there is
cognitive skills (Stern, 2012). Angel, Fay, Bouazzaoui, no research offering normative performance data for the
Baudouin, and Isingrini (2010) refer to the interaction Brazilian elderly in this subtest. Accordingly, this study
between age and education in performing a wordlist had three main goals:
recalling task, in which adults with lower levels of educa- 1. to provide reference normative data for the elderly
tion performed poorly when compared with those with Brazilian population in the LM subtest;
higher levels of formal education. Although it is expected 2. to check the impact of age, education, gender, and de-
that some cognitive skills decline with age, some changes pressive symptoms on the LM subtest performance; and
are clearly associated with education (Beydoun et al., 3. to verify the LM capacity to discriminate the elderly
2014). Foss, Formigheri and Speciali (2009), for exam- with and without depressive symptoms.
ple, find significant positive correlations between level of
education and performance in VEM tests in the elderly. Method
Among other sociodemographic characteristics, gen-
der has been studied with the aim of explaining changes Participants
in cognitive performance. However, especially in assess- The sample comprised elderly subjects over 60 years
ing mnemonic deficits, studies show contradictory results of age, according to the World Health Organization for
comparing men and women (Chapman et al., 2011b). developing countries (WHO, 2002), and with different
There is evidence that depressive symptoms also influence cultural and educational backgrounds. The participants
VEM performance. In a longitudinal study, Koening et al. were selected from the Family Health Strategy Program,
(2014) realized that elderly with a history of depression EMISUS-FHSP (Gomes et al., 2013) in Porto Alegre,
showed a decline in several cognitive skills, among them Brazil. The elderly from FHSP were randomly selected
VEM. Also Pantzar et al. (2014), in a sample of elderly from two neighborhoods in Porto Alegre and they were
subjects, identified that serious depressive symptoms were assessed by neurologists, psychiatrics, psychologists, and
associated with lower performance in attention tasks, ex- nutritionists. Initially, 460 elders were included in the
ecutive functions, and VEM. study, and the exclusion criteria were:
VEM could be assessed through learning/recalling 1. scores suggestive of cognitive decline in the Mini
wordlists or through retelling stories (Beck, Gagneux- Mental State Examination (adapted by Bertolucci,
Zurbriggen, Berres, Taylor, & Monsch, 2012; Lezak, Brucki, Campacci, & Juliano, 1994), according to the
Howieson, Bigler, & Tranel, 2012). In both tests, codifica- cutoff points suggested by Kochhann, Varela, Lisboa,
tion, storage, and recall processes are observed. Examples and Chaves (2010) that are suitable for the elderly
of wordlist tests are the Rey Auditory Verbal Learning population in south Brazil (21 points for illiterate,
Test and the California Verbal Learning Test (Lezak et al., 22 for 1-5 years in formal education, 23 for 6-11, and
2012). These tests have the advantage of checking as- 24 for 12 or more years);
sociation strategies used to recall data — for example, 2. not completing the evaluation battery; and
sorting out words according to clues as to their semantic 3. self-reported psychiatric or neurologic diagnosis.
or phonological categories, as well as effects of primacy
and recency (Sunderaraman, Blumen, DeMatteo, Apa, & Therefore, the final sample included 334 elderly
Cosentino, 2013). Furthermore, performance in various participants between the ages of 60 and 95 years old
trials allows the development of learning curves. (M=67.82; SD=6.41), between 0 and 15 years of formal
In recalling stories tests, the examiner reads a short education (M=5.02; SD=3.04): 213 (64%) were women
story and then asks the participant to retell it. These and 121 (36%) were men. As for their civil status, 121
tasks have a higher level of difficulty as they require (36%) participants were married, 92 (28%) widowers, 52
new cognitive skills such as inferential processing (mor- (16%) single, 64 (18%) divorced, and 5 (2%) not answered.
al of the story) and work memory (Welland, Lubinski, In the subjective health evaluation, 120 (36%) participants
& Higginbotham, 2002). In addition, they have higher rated excellent/good, 164 (49%) regular, 26 (8%) bad/aw-
ecological validity when compared to other VEM tests ful, and 24 (7%) did not answer. Furthermore, 207 (62%)
(Higginson, Arnett, & Voss, 2000), demonstrating a participants were retired and 77 (23%) earned up to one
strong association with subjective cognitive complaints minimum salary, 148 (44%) up to three, 28 (8%) up to six,
in the healthy elderly (Merema, Speelman, Kaczmarek, 5 (3%) up to 10, 1 (1%) more than 10, and 75 (21%) did
& Foster, 2012). not answer. In relation to depressive symptoms, 73 (22%)

12 Avaliação Psicológica, 2017, 16(1), pp. 1-18

 Logical memory normative data of Brazilian elders

participants had a score ≥6 on the Geriatric Depression LM test performance were verified by multiple linear
Scale, short form — GDS-15. regression analysis (stepwise method). Analysis of error
independence was investigated with the Durbin-Watson
Procedures and instruments statistics. Participants without significant depressive
Participants were assessed in a session of approxi- symptoms were distributed into groups according to age
mately 90 minutes, and tests was administered according (60-69 years old, 70-79, and 80+), education (illiterate –
to the following sequence: with zero years of study, 1-4, 5-8, and 9+), and gender.
1. consent form; Student’s t test was used for independent samples and
2. sociodemographic and health questionnaire (to inves- analysis of variance (ANOVA) with post hoc Bonferroni
tigate age, education, gender, retirement, subjective (to provide greater control against type I error) to identi-
perception of health, income, marital status, and his- fy differences in the LM subtest performance in groups.
tory of clinical diagnosis); Normative data for each group were reported through
3. MMSE: a screening test that provides temporo-spa- the means and standard deviations values, and scores
tial orientation, registration, attention/calculation, related to cutoff point of 1.5 standard deviation below
recall, and language measures, whose total score the average {z-score=[(participant score - control group
ranges between 0 and 30 points. The cutoff points average)/control group standard deviation]}. Finally, a
suggested by Kochhann et al. (2010) are suitable for stepwise discriminant analysis was carried out following
the elderly in southern Brazil and present sensitivity Wilks’s method to check the capacity of the LM sub-
between 81% and 93% and specificity between 82% test scores to estimate to which group the participant
and 87%; belongs (presence or absence of depressive symptoms).
4. LM subtest (immediate recall) of WMS-R (Wechsler, Normality assumptions and homogeneity of the varianc-
1987); es–covariances of each group were tested, respectively,
5. a visual distractor task; with the Shapiro–Wilk and the M of Box tests. Results
6. LM subtest (delayed recall); and were considered statically significant at p≤.05.
7. GDS-15 (adapted by Almeida & Almeida, 1999): a scale
composed of 15 dichotomous questions (“yes” and Results
“no”) concerning the occurrence of depressive symp-
toms. There are several cutoff points suggested in the Table 1 presents the results for the explanatory
literature for the short version, but the adopted values models of multiple linear regression for immediate and
for case/non-case (6/5) present considerable degree of delayed recall of the LM subtest. Predictive variables
sensitivity (between 80% and 85%) and specificity (be- were education, age, gender, and depressive symptoms.
tween 71% and 78%) for the Brazilian elderly (Pinho, In immediate recall, correlation between significant
Custódio, Makdisse, & Carvalho, 2010). variables to the model (education, age, and depressive
symptoms) was moderate (multiple R=.372). These
The LM subtest consists of two short stories that variables were responsible for 13.80% of the variance
are read to the participants. In immediate recall, the el- of verbal information immediate recall. Results showed
derly have to recall details of stories after having listened that years of formal education were positively related
to them; in the 30-minute delayed recall, once again the to the immediate recall performance, while age and
elderly have to recall details of the stories. The score com- depressive symptoms correlated negatively. Patterned
prises the sum of correct information recalled (immediate coefficients of regression showed that education has a
and delayed), adding up to a score of 25 in both trials. In its higher impact than any other variable on that model
original version, the LM subtest has a high level of inter- (p≤.001), followed by age (p≤.001) and depressive
nal consistency, adequate test-retest reliability coefficients, symptoms (p=.012).
and evidence of construct, criterion, and discriminant va- In what concerns delayed recall, all variables had
lidity (Strauss, Sherman, & Spreen, 2006). a significant impact on the model, showing a moder-
This study was approved by the Research Ethics ate correlation (multiple R=.468), which accounts for
Committee of PUCRS (protocol no. 10/04967). 21.90% of the variance in performance. Age and depres-
sive symptoms showed negative correlations, whereas
Statistical analysis education and female gender showed positive correla-
All data analyses were carried out using the soft- tions. According to patterned coefficients of regression,
ware Statistical Package for the Social Sciences version it was clear that the variable with the highest impact on
22 for Windows. Descriptive analysis comprised means, delayed recall was education (p≤.001), followed by age
standard deviations, and absolute and relative frequency. (p≤.001), gender (p≤.001), and depressive symptoms
Normality of data distribution was investigated with the (p=.006).
Kolmogorov-Smirnov test. Effects of the variables, age, According to the analysis of influence of educa-
education, gender, and depressive symptoms, on the tion, age, gender, and depressive symptoms on the LM

Avaliação Psicológica, 2017, 16(1), 1-18 13

 Oliveira, C. R., Lima, M. M. B. M. P., Esteves, C. S., Gonzatti, V., Viana, S. A. R., Irigaray, T. Q., & Argimon, I. I. L.

test performance, participants were distributed in differ- groups (60-69 years old, 70-79, and 80+), four educa-
ent normative groups. Table 2 presents the means and tion groups (illiterate, 1-4 years of education, 5-8, and
standard deviations in immediate recall from three age 9+), gender, and depressive symptoms. It should be

Table 1
Multiple Linear Regression Models for Immediate and Delayed Recall Scores of the ML Subtest
Models b±SE B t 95%CI R2 R 2a F p
Immediate recall (n=334)
Step 3
Constant 23.247±3.381 – 6.875 16.595 – 29.898
Education (years) .544±.102 .275 5.345 .344 – .745
Age (years) -.160±.048 -.170 -3.317 -.254 – -.065 .138 .131 17.684 ≤.001
GDS-15 (score) -.258±.102 -.130 -2.533 -.458 – -.058
Delayed recall (n=334)
Step 4
Constant 18.470±3.340 – 5.529 11.899 – 25.041
Education (years) .647±.101 .316 6.396 .448 – .846
Age (years) -.201±.048 -.207 -4.226 -.295 – -.107
.219 .209 23.036 ≤.001
Sex (female) 2.490±.644 -.193 3.866 1.223 – 3.758
GDS-15 (escore) -.280±.102 -.136 -2.741 -.481 – -.079
Note: CI=Confidence interval; R a=adjusted R ; df=333.
2 2

Table 2
Performance Comparison and Normative Data for Immediate and Delayed Recall Scores of the ML Subtest
Immediate recall Delayed recall
z z
M DP score F p Post hoc M DP score F p Post hoc
(-1.5) (-1.5)
Age groups
(n=261)┼
60–69 (n=168) 15.04 6.25 5 9.82 6.33 0
60-
70–79 (n=77) 14.22 5.63 5 3.086 .047 7.87 6.35 0 7.329 ≤.001 60-69> 80+**
69>80+*
80+ (n=16) 11.25 4.95 3 4.31 2.89 0
Education
groups (n=261)┼
Illiterate (n=14) 14.07 4.91 6 3.71 4.41 0
Illiterate<5-8**
1–4 (n=105) 12.71 5.74 4 1-4<5-8*** 7.38 5.71 0 Illiterate<9+***
8.075 ≤.001 10.322 ≤.001
5–8 (n=103) 15.30 5.67 6 1-4<9+*** 9.99 6.41 0 1-4<5-8**
1-4<9+***
9+ (n=39) 17.77 6.59 7 12.03 6.26 2
┼
Sex (n=261)
Female (n=155) 15.05 5.78 6 10.08 6.18 0
2.085 .115 – .618 ≤.001 –
Male (n=106) 13.85 6.38 4 7.19 6.20 0
Depressive
symptoms (n=334)
Absence (n=261) 14.56 6.05 5 8.91 6.34 0
.294 .018 – .932 .074 –
Presence (n=73) 12.68 5.66 4 7.44 5.68 0
Note: ┼We included only participants with scores between 0 and 5 in the GDS-15; *p≤.05; ***p≤.001; df (age groups) = 258; df (edu-
cation groups) = 257; df (sex) = 259; df (depressive symptoms) = 332.

14 Avaliação Psicológica, 2017, 16(1), pp. 1-18

 Logical memory normative data of Brazilian elders

highlighted that, as depressive symptoms have an im- According to studies (Chapman et al., 2011b; Silver et al.,
pact on two of the three LM test scores, participants with 2012), the main variables that have an impact on LM
six points or more on the GDS-15 were not included in subtest are age, education, and gender.
groups by age, education, and gender. Normative data According to the regression models for immedi-
for all groups are presented according to average, stan- ate and delayed recall scores, results demonstrated that
dard deviation, and z-score. age and education were negatively and positively corre-
ANOVA demonstrated the impact of age, educa- lated, respectively, which are according to the literature
tion, and depressive symptoms on immediate recall (Shi et al., 2014). Gender also proved to have an effect
scores. The post hoc analysis showed that the age group 60- on two LM scores, as women scored higher than men.
69 years obtained significantly higher scores than the 80+ Depressive symptoms correlated negatively with im-
years group in immediate recall, i.e., the younger elderly mediate and delayed recall performance. Our results
recalled more details than the older elderly. However, suggested that the older elderly scored significantly lower
no other significant differences were identified between when compared to the younger age group. According to
the remaining age groups. In what concerns education, Cansino (2009), episodic memory is particularly vulner-
performance of the 1-4 years of education group was sig- able to aging, once contextual information or details of
nificantly lower than the 5-8 and 9+ groups. This group the moment/episode are susceptible to be forgotten than
demonstrated worse scores than the more educated the event itself. In the aging process, changes occur both
groups, and its results were similar to the illiterate group. in memory acquisition and in recalling new information
Furthermore, participants with depressive symptoms (Quevedo, Martins, & Izquierdo, 2006).
demonstrated worst performance than participants with- The effect of age on the performance of VEM may
out depressive symptoms. No differences were found be associated with the recruitment of several brain re-
between men and women in immediate recall scores. gions and neural networks as a result of the aging process,
According to the ANOVA of the delayed recall score such as the HAROLD (Cabeza, 2002) and PASA mod-
(Table 2), post hoc results among age groups showed, once els (Davis, Dennis, Daselaar, Fleck, & Cabeza, 2008).
again, that the younger elderly (60–69 years) scored While the information processing in young adults shows
higher than the older elderly (80+ years). There were higher asymmetry between hemispheres, older adults
no other significant differences among the remaining age tend to present lower lateralization. Besides, the elderly
groups. Conforming to the post hoc for education levels, demonstrate higher activation in the anterior regions of
illiterate and 1-4 years of education groups scored signif- the cerebral cortex when performing cognitive activities,
icantly lower than the 5-8 and 9+ groups. Comparisons suggesting a functional compensation.
according to gender showed that women scored higher In what concerns VEM, there is a higher involve-
in delayed recall than men. There were no significant ment of the frontal cortex in recalling information
performance differences between groups with and with- processes. Based on techniques of neuroimaging, perfor-
out depressive symptoms. Discriminant analysis with mance in immediate and delayed recall in VEM tasks was
the stepwise method extracted a discriminant function, associated with volume of the right hippocampus and
keeping as statistically significant immediate recall score the left dorsolateral prefrontal cortex (Cox et al., 2015).
explaining 100% of the variability between the with Consequently, the elderly recruit different cerebral ar-
and without depressive symptoms groups (Ʌ=.983; eas to efficiently perform memorization steps, showing
χ2=5.606; p=.041). The percentile of correctly classified a compensation effect. The hippocampus can also be
participants was 56%. activated when correlating recently learnt associations
(Shing et al., 2010).
Discussion Corroborating these results, Kinugawa et al.
(2013), while comparing three different age groups,
The current study had three main goals. The first one observed that the decline in VEM increased with age.
was to provide normative reference data to the Brazilian In assessments with LM, Kawano et al. (2013) iden-
elderly in the LM subtest of the WMS-R. The second tified a negative correlation with age, but not with
goal was to identify the effects of age, education, gender, education or gender. In another example, Silver et al.
and depressive symptoms on the LM subtest perfor- (2012) observed that the elderly scored low when com-
mance. Finally, the third goal was to identify immediate pared with young in LM. Furthermore, the authors
and delayed recall scores capacity to identify the elderly identified a moderate correlation between work mem-
with and without depressive symptoms. ory and verbal memory. Similarly, our results show that
Several studies have tried to provide normative the younger elderly achieved better performance in all
data for the elderly in LM subtest throughout differ- modalities of the LM subtest compared with the older
ent countries (Chapman et al., 2011b; Kawano, Awata, group (80 years or more).
Ijuin, Iwamoto, & Ozaki, 2013); however, there were This study demonstrated that the elderly with lower
no normative data performance for the Brazilian elderly. levels of education (illiterate and 1-4) scored poorly in

Avaliação Psicológica, 2017, 16(1), 1-18 15

 Oliveira, C. R., Lima, M. M. B. M. P., Esteves, C. S., Gonzatti, V., Viana, S. A. R., Irigaray, T. Q., & Argimon, I. I. L.

the LM subtest compared with the higher educational activities, medication, sociocultural background, alcohol,
groups. These results are consistent with those of Nitrini and tobacco addictions are not studied. These character-
(2008), and other studies also showed positive correla- istics, which were not considered in this study, could
tions between education and VEM tasks (Gabriel & explain the differences between genders in LM scores.
Conboy, 2010; Messinis et al., 2016). In the study of Depressive symptoms impacted the performance
Angel et al. (2010) four groups were assessed according on the LM subtest in both immediate and delayed recall.
to age (young and elderly) and education (low and high) Furthermore, immediate recall score classified correctly
in a VEM test. Information recall score was lower in the 56% of the participants according to the absence or presence
elderly group, and older participants with lower levels of depressive symptoms. Some studies highlight the effect
of education obtained the worst accuracy. Furthermore, of depressive symptoms in cognition (Graziane, Beer, Snitz,
education acted as a protective factor, preventing decline Chang, & Ganguli, 2016). Depressive symptoms may be
of mnemonic abilities associated with aging. correlated to a lower attention level, which directly impacts
Another possible explanation for the poorer perfor- acquisition and storage of verbal information, and attention
mance of less-educated adults in the LM subtest could level. Qualitative analyses of wordlist tasks showed a dif-
be the cognitive reserve (Stern, 2012), since the activi- ference in performance between subjects with dementia
ties performed throughout the life span can contribute and depressive symptoms, as they showed a higher usage of
to strengthening and establishing new information contextual clues (Strauss et al., 2006).
networks, mainly to solve complex tasks. The level of It is important to highlight that comparison of
education seems to increase information association results of the present study with the results of other
networks in the cerebral cortex, which have an effect on studies is a delicate task, as the samples differ according
processing speed and effective information acquisition, to cultural backgrounds. It is necessary to set norma-
storage, and recall. The elderly with higher levels of edu- tive performance patterns, irrespective of the cognitive
cation show a better learning than the less-educated ones construct, consistent with sociocultural reality of the
and therefore perform better at storing and recalling in- respective country. For example, the distribution of nor-
formation (Angel et al., 2010). mative groups into age and education levels reflects an
The results related to the influence of gender on adjustment according to sociodemographic characteris-
the LM subtest seem to be contradictory. Chapman, tics, whereas depression is a confounding factor in the
Mapstone, Gardner, et al. (2011) compared the LM diagnosis of neurodegenerative diseases.
performance of male and female elderly with AD and Our main results showed that the LM subtest corre-
healthy male and female elderly. The authors conclud- lates to age, education, depressive symptoms, and gender.
ed that female elderly with AD scored lower than male However, subjects with cognitive decline or dementia
elderly with AD in both immediate and delayed recall. were not included in this study, and it is necessary to
However, the opposite pattern was observed in the investigate these clinical populations in future research.
healthy group, in which the female elderly scored higher Another serious limitation was the number of partici-
than the male. A discriminant analysis was carried out by pants in each normative group and, more specifically,
the authors, which showed that LM scores best identi- the number of participants in some age and education
fied AD in women than in men. groups was not homogeneous.
It is possible that the different findings related to Dementia and neurodegenerative diseases are com-
gender in VEM performance are based on the individual mon among older people and represent a problem of
and cultural differences of the samples studied. Once public health. Consequently, valid and reliable neuro-
again the cognitive reserve can be a distracting variable psychological assessment tasks are required for more
when analyzing the role of gender in cognition. In stud- accurate diagnoses. Hence, the results of this study are
ies focused on the rural population, for example, a higher important as they provide normative data for a task that
effect of correlation between gender and education can assesses VEM, which is widely used for the cognitive as-
be identified (Yang et al., 2012). Besides professional sessment of the elderly in clinical practice and research.

References

Almeida, O. P., & Almeida, S. A. (1999). Confiabilidade da versão brasileira da Escala de Depressão em Geriatria (GDS) versão reduzida.
Arquivos de Neuropsiquiatria, 57(2-B), 421-426. doi: 10.1590/S0004-282X1999000300013
Angel, L., Fay, S., Bouazzaoui, B., Baudouin, A., & Isingrini, M. (2010). Protective role of educational level on episodic memory aging:
An event-related potential study. Brain and Cognition, 74(3), 312-323. doi: 10.1016/j.bandc.2010.08.012

16 Avaliação Psicológica, 2017, 16(1), pp. 1-18

 Logical memory normative data of Brazilian elders

Beck, I. R., Gagneux-Zurbriggen, A., Berres, M., Taylor, K. I., & Monsch, A. U. (2012). Comparison of verbal episodic memory measures:
Consortium to Establish a Registry for Alzheimer’s Disease - Neuropsychological Assessment Battery (CERAD-NAB) versus
California Verbal Learning Test (CVLT). Archives of Clinical Neuropsychology, 27(5), 510-519. doi: 10.1093/arclin/acs056
Bertolucci, P. H. F., Brucki, S. M. D., Campacci, S. R., & Juliano, Y. (1994). O Mini-Exame do Estado Mental em uma população geral:
impacto da escolaridade. Arquivos de Neuropsiquiatria, 52(1), 1-7.
Beydoun, M. A., Beydoun, H. A., Gamaldo, A. A., Teel, A., Zonderman, A. B., & Wang, Y. (2014). Epidemiologic studies of modifiable
factors associated with cognition and dementia: Systematic review and meta-analysis. BMC Public Health, 14, 643. doi: 10.1186/1471-
2458-14-643
Cabeza, R. (2002). Hemispheric asymmetry reduction in older adults: The HAROLD model. Psychology and Aging, 17(1), 85-100. doi:
10.1037/0882-7974.17.1.85
Cansino, S. (2009). Episodic memory decay along the adult lifespan: A review of behavioral and neurophysiological evidence. International
Journal of Psychophysiological, 71(1), 64-69. doi: 10.1016/j.ijpsycho.2008.07.005
Celsis, P. (2000). Age-related cognitive decline, mild cognitive impairment or preclinical Alzheimer’s disease? Annals of Medicine, 32(1), 6-14.
doi: 10.3109/07853890008995904
Chapman, R. M., Mapstone, M., Gardner, M. N., Sandoval, T. C., McCrary, J. W., Guillily, M. D., et al. (2011b). Women have farther to
fall: Gender differences between normal elderly and Alzheimer’s disease in verbal memory engender better detection of Alzheimer’s
disease in women. Journal of International Neuropsychological Society, 17(4), 654-662. doi: 10.1017/S1355617711000452
Chapman, R. M., Mapstone, M., McCrary, J. W., Gardner, M. N., Porsteinsson, A., Sandoval, T. C., et al. (2011a). Predicting conversion
from mild cognitive impairment to Alzheimer’s disease using neuropsychological tests and multivariate methods. Journal of Clinical and
Experimental Neuropsychology, 33(2), 187-199. doi: 10.1080/13803395.2010.499356
Correia, F. A., & Osorio, I. C. (2013). The Rey Auditory Verbal Learning Test: Normative data developed for the Venezuelan population.
Archives of Clinical Neuropsychology, 29(2), 206-215. doi: 10.1093/arclin/act070
Cox, S. R., Bastin, M. E., Ferguson, K. J., Allerhand, M., Royle, N. A., Maniega, S. M., et al. (2015). Compensation or inhibitory failure?
Testing hypotheses of age-related right frontal lobe involvement in verbal memory ability using structural and diffusion MRI. Cortex,
63C, 4-15. doi: 10.1016/j.cortex.2014.08.001
Davis, S. W., Dennis, N. A., Daselaar, S. M., Fleck, M. S., & Cabeza, R. (2008). Que PASA? The posterior-anterior shift in aging. Cerebral
Cortex, 18(5), 1201-1209. doi: 10.1093/cercor/bhm155
Foss, M. P., Formigheri, P., & Speciali, J. G. (2009). Heterogeneity of cognitive aging in Brazilian normal elderls. Dementia & Neuropsychologia,
3(4), 344-351.
Gabriel, P., & Conboy, J. (2010). Atenção e memória visual na população idosa: uma associação entre habilidades literárias sob condições de
interferência. Cuadernos de Neuropsicología, 4(2), 186-201.
Gomes, I., Nogueira, E. L., Engroff, P., Ely, L. S., Schwanke, C. H. A., De Carli, G. A., et al. (2013). The multidimensional study of the
elderly in the family health strategy in Porto Alegre, Brazil (EMI-SUS). Pan American Journal of Aging Research, 1(1), 20-24.
Graziane, J. A., Beer, J. C., Snitz, B. E., Chang, C. C., & Ganguli, M. (2016). Dual trajectories of depression and cognition: A longitudinal
population-based study. American Journal of Geriatric and Psychiatry, 24(5), 364-373. doi: 10.1016/j.jagp.2015.08.001
Higginson, C. I., Arnett, P. A., & Voss, W. D. (2000). The ecological validity of clinical tests of memory and attention in multiple sclerosis.
Archives of Clinical Neuropsychology, 15(3), 185-204. doi: 10.1093/arclin/15.3.185
Kawano, N., Awata, S., Ijuin, M., Iwamoto, K., & Ozaki, N. (2013). Necessity of normative data on the Japanese version of the Wechsler Memory
Scale-Revised Logical Memory subtest for old-old people. Geriatrics & Gerontology International, 13(3), 726-730. doi: 10.1111/ggi.12007
Kinugawa, K., Schumm, S., Pollina, M., Depre, M., Jungbluth, C., Doulazmi, M., et al. (2013). Aging-related episodic memory decline: Are
emotions the key? Frontiers in Behavioral Neuroscience, 7, 2. doi: 10.3389/fnbeh.2013.00002
Kochhann, R., Varela, J. S., Lisboa, C. S. M., & Chaves, M. L. F. (2010). The Mini Mental State Examination: Review of cutoff points
adjusted for schooling in a large Southern Brazilian sample. Dementia and Neuropsychologia, 4(1), 35-41.
Koenig, A. M., DeLozier, I. J., Zmuda, M. D., Marron, M. M., Begley, A. E., Anderson, S. J., et al. (2014). Neuropsychological functioning
in the acute and remitted states of late-life depression. Journal of Alzheimers Disease, 45(1), 175-85. doi: 10.3233/JAD-148006
Laske, C., Sohrabi, H. R., Jasielec, M. S., Müller, S., Koehler, N. K., Gräber, S. et al. Dominantly Inherited Alzheimer Network (DIAN)
(2015). Diagnostic value of subjective memory complaints assessed with a single item in Dominantly Inherited Alzheimer’s Disease:
Results of the DIAN Study. BioMed Research International, 2015(4), 1-7. doi: 10.1155/2015/828120
Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological Assessment. New York, USA: OXFORD.
Maeshima, H., Baba, H., Nakano, Y., Satomura, E., Namekawa, Y., Takebayashi, N., et al. (2013). Time course for memory dysfunction in
early-life and late-life major depression: A longitudinal study from the Juntendo University Mood Disorder Project. Journal of Affective
Disorders, 151(1), 66-70. doi: 10.1016/j.jad.2013.05.050
Merema, M. R., Speelman, C. P., Kaczmarek, E. A., & Foster, J. K. (2012). Age and premorbid intelligence suppress complaint-performance
congruency in raw score measures of memory. International Psychogeriatrics, 24(3), 397-405. doi: 10.1017/S1041610211001918
Messinis, L., Nasios, G., Mougias, A., Politis, A., Zampakis, P., Tsiamaki, E., et al. (2016). Age and education adjusted normative data and
discriminative validity for Rey’s Auditory Verbal Learning Test in the elderly Greek population. Journal of Clinical and Experimental
Neuropsychology, 38(1), 23-39. doi: 10.1080/13803395.2015.1085496
Nitrini, R. (2008). Immediate recall of short stories depends on educational level. Dementia & Neuropsychologia, 2(4), 310-314.
Pantzar, A., Laukka, E. J., Atti, A. R., Fastbom, J., Fratiglioni, L., & Bäckman, L. (2014). Cognitive deficits in unipolar old-age depression:
A population-based study. Psychological Medicine, 44(5), 937-947. doi: 10.1017/S0033291713001736
Pinho, M. X., Custódio, O., Makdisse, M., & Carvalho, A. C. C. (2010). Confiabilidade e validade da escala de depressão geriátrica em
idosos com doença arterial coronariana. Arquivos Brasileiros de Cardiologia, 94(5), 570-579. doi: 10.1590/S0066-782X2010005000032
Quevedo, J., Martins. M. R., & Izquierdo, I. (2006). Alterações cerebrais e memória. In C. M. C. Bottino, J. Laks, & S. L. Blay (Eds.),
Demência e transtornos cognitivos em idosos (pp 3-12). Rio de Janeiro: Guanabara Koogan.
Salthouse, T. A. (2014). Correlates of cognitive change. Journal of Experimental Psychology – General, 143(3), 1026-1048. doi: 10.1037/a0034847
Shi, J., Wei, M., Tian, J., Snowden, J., Zhang, X., Ni, J., et al. (2014). The Chinese version of story recall: A useful screening tool for mild
cognitive impairment and Alzheimer’s disease in the elderly. BMC Psychiatry, 14, 71. doi: 10.1186/1471-244X-14-71

Avaliação Psicológica, 2017, 16(1), 1-18 17

 Oliveira, C. R., Lima, M. M. B. M. P., Esteves, C. S., Gonzatti, V., Viana, S. A. R., Irigaray, T. Q., & Argimon, I. I. L.

Shing, Y. L., Werkle-Bergner, M., Brehmer, Y., Müller, V., Li, S. C., & Lindenberger, U. (2010). Episodic memory across the lifespan:
The contributions of associative and strategic components. Neuroscience and Biobehavioral Reviews, 34(7), 1080-1091. doi: 10.1016/j.
neubiorev.2009.11.002
Silver, H., Goodman, C., & Bilker, W. B. (2012). Impairment in associative memory in healthy aging is distinct from that in other types of
episodic memory. Psychiatry Research, 197(1-2), 135-139. doi: 10.1016/j.psychres.2012.01.025
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurology, 11(11), 1006-1012. doi: 10.1016/S1474-
4422(12)70191-6
Strauss, E., Sherman, E., & Spreen O. (2006). A compendium of neuropsychological tests. New York: Oxford University Press.
Sunderaraman, P., Blumen, H. M., DeMatteo, D., Apa, Z. L., & Cosentino, S. (2013). Task demand influences relationships among sex,
clustering strategy, and recall: 16-word versus 9-word list learning tests. Cognitive and Behavioral Neurology, 26(2), 78-84. doi: 10.1097/
WNN.0b013e31829de450
Vlahou, C. H., Kosmidis, M. H., Dardagani, A., Tsotsi, S., Giannakou, M., Giazkoulidou, A., et al. (2013). Development of the Greek Verbal
Learning Test: Reliability, construct validity, and normative standards. Archives of Clinical Neuropsychology, 28(1), 52-64. doi: 10.1093/
arclin/acs099
Wechsler, D. (1987). Wechsler Memory Scale – Revised. San Antonio, Texas: Pearson.
Welland, R. J., Lubinski, R., & Higginbotham, D. J. (2002). Discourse comprehension test performance of elders with dementia of the
Alzheimer type. Journal of Speech, Language and Hearing Research, 45, 1175-1187. doi: 10.1044/1092-4388(2002/095)
WHO – World Health Organization (2002). Active ageing: A police framework. A contribution of the World Health Organization to the second United
Nations World Assembly on Aging. Madrid: WHO.
Yang, L., Unverzagt, F. W., Jin, Y., Hendrie, H. C., Liang, C., Hall, K. S., et al. (2012). Normative data for neuropsychological tests in a rural
elderly Chinese cohort. Clinical Neuropsychology, 26(4), 641-653. doi: 10.1080/13854046.2012.666266

received on february, 2016

reviewed on june, 2016
approved on july, 2016
About the authors

Camila Rosa de Oliveira is a Psychologist by Federal University of Rio Grande do Sul (UFRGS). PhD in Biomedical Gerontology
by Pontifical Catholic University of Rio Grande do Sul (PUCRS). Master in Psychology (emphasis on human cognition) by PUCRS.
Professor of the Postgraduate Program in Psychology at Faculdade Meridional IMED.
Margarida Maria Baptista Mendes Pedroso de Lima is a Psychologist by University of Coimbra. PhD in Psychology by
University of Coimbra. Master of Science in Education by University of Coimbra.
Cristiane Silva Esteves is a Psychologist by PUCRS. PhD in Biomedical Gerontology by PUCRS. Master in Psychology (emphasis
in clinical psychology) by PUCRS.
Valéria Gonzatti is a Psychologist by Lutheran University of Brazil (ULBRA). Master in Psychology (emphasis in clinical psychology)
by PUCRS. Specialist in neuropsychology by UFRGS.
Susy Ane Ribeiro Viana is a Psychologist by Centro Universitário do Norte (UNINORTE). Master in Biomedical Gerontology
by PUCRS.
Tatiana Quarti Irigaray is a Psychologist by UFRGS. Post-doctorate in Psychology by PUCRS. PhD and Master in Biomedical
Gerontology by PUCRS. Professor of the Postgraduate Program in Psychology at PUCRS.
Irani Iracema de Lima Argimon is a Psychologist by PUCRS. PhD in Psychology by PUCRS. Master in Education by PUCRS.
Professor of the Postgraduate Programs in Psychology at PUCRS and Biomedical Gerontology at PUCRS.

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